March 17-19
I passed this weekend at Syracuse. I feel stunned that it is over as I did not plan life after March 19th. Nothing mattered except this CPNE.
First of all I want all those who are anticipating their own CPNE, that this is soooooooo doable. I took NO workshops. Do not rely on the conventional wisdom from some of the yahoo groups. The ultimate authority is the studyguide. If you know it,do not chase someone's opinion that conflicts. Verify everything.
I did not touch a book or a note the week before my test. My Dear Husband ( DH) kept me occupied without me even realizing that he was doing it. I got a massage on Thursday to loosen up all the knots I got from being hunched over my books for months.My DH had a dozen red roses delivered to me with a card that read" Babe, relax,you will do fine, your sweetie" I kept that card with me the whole CPNE. I printed up a very positive experience and an encouraging email to keep in the car and read before I went in.
I will write my experience in several installments and give as much details as I can.I passed all Labs and PCS with NO repeats.
I obsessed about the right thing to wear on Friday afternoon and finally decided to wear some green because It was St Patricks day. I was supposed to meet DH for lunch Friday but he could not get away. I made back up plans to meet a good friend but last minute his elderly mother needed him. I was upset to be alone to drive the hour to Syracuse alone.
I easily found the St Joes school of nursing. Slowly students filtered into the lobby. There was 5 women. Two from NY, one from PA and two from CA. I decided to set the tone and declared that we had a fine group and I had a good feeling about all of us. I got a few nervous smiles but I decided that I would go in optimistic. We met our CA, Mary, a very Irish woman who also was the director of the St Joes school of nursing!!
We got the whole thing out of the manual.We drew card to get our assignments. I got 1A.
Then to the Labs. When we were allowed to look at the stations ahead of time, I ripped dressings off the mannequins, opened packages , tried on gloves etc.This was MY test. I was looking good and hard.
My first was the IV push lab. I contaminated the syringe by picking it up by the barrel of the plunger of all things!! I caught myself and started over.Everything else went smoothly. The CEs were so relaxed and non intimidating!.2 of the women with me had to redo labs.
My first CE was Peg. I could tell she had a quick wit . We walked out into the cold to the hospital.I got the info on my first patient and my assignment. I had a woman with possible pneumonia, urethral calculi,hydronephrosis,post 2 day stent placement,post brain aneurysm,fibromyalgia.
I was assigned: along with all the usual required AOC, comfort management, respiratory management,medications.Assess pain,assess O2 sat
I drove home elated and obsessing about the next day.
I will write more ...............
Yvonne Bush GN.
okay...onward........ I drove the hour home Friday feeling great that I did not have a repeat lab hanging over my head.I was already working on a careplan in my head.I got home and kissed DH ( Dear Husband) . I sat down and read the kardex twice. I got out my trusty highlighter and marked the areas I needed to fill in on the entire packet. This is my careplan initially......Impaired comfort r/t calculi aeb patient rates pain a ------ on a 0-10 scale ......Goal:patient will rate pain a 3 or less'.......interventions !) assess pain 2) ask primary nurse to medicate with ordered analgesic.
NDX2: Ineffective airway clearance r/t retained secretions aeb abnormal lung sounds. I made a practice grid on a separate piece of paper.I went to bed about 930 PM and slept until 2 am. I had dreams of letters and mnemonics. I finally gave up and showered. I packed each morning some dark chocolate for the benefit of flavanoids and some Greek sesame honey candy,32 ounces of water. Each morning I had a protein shake with a banana in it'd was not sure something else would have stayed down.
I got to the Hospital a bit early and parked in the hospital garage . It is not the best neighborhood so I did not want to leave it on the street, but the rates of the garage was larceny anyways!!! We all filtered in the cafeteria which is pretty nice and dirt cheap with a lot of variety. The students gathered at one table and the CEs at another. We all ended up talking about our assignments even though we were encouraged not to.One by one we got picked up by our assigned CE. I went to the urinary/renal floor .The units at St Joes have the utility rooms in the center , the main nursing station on one end and the rooms are all on the outer areas. There are pods..Or mini nurses stations in niches along the inner block . Each pod serves 3 rooms and has the meds for those rooms as well as the computer for charting there. My CE warned me that my patient was talkative and I nay need to guide her with getting accomplished.As I was in planning she had gotten up to the bathroom and did not void again so I was set there.While doing checks, I noticed that her IV site was edematous so I had to get the primary nurse who did not seem concerned. The patient was upset . There was extensive bruising on her arms from multiple failed IVs.All in all she was a peach, wanting to make my job easier.She rated her painan 8/10 but that included her fibromyalgia too..I notified primary and changed my careplan and told the CE I was including the fibromyalgia in the etiology for the impaired comfort..While she was eating I went out to get her meds.I returned and someone had picked up her tray!!!! The patient was teary and said" I told them to leave it for you" The CE picked her tray off the cart for me...thank goodness it still had the ticket on it.I ended up not getting the blood pressure on her because of ther severly bruised arms . We attempted a leg BP but her fibromyalgia was pretty bad so I invoked CDM and CE agreed.Her lungs were pretty junky and she was cooperative with Resp management.It was a bit difficult to get her to accept comfort management as she thought it wasnt fair to have the student do all of that. I finally convinced her that she was doing ME the favor. I washed her itchy back and gave her a massage. I ambulated her around the block as I had time and she talked the whole time!!.I finished what I had to and out I went. I was out in a patient lounge to chart and put earplugs in to help me concentrate.I handed in my paper............Peg asked me if I needed to get a drink. I dont think she wanted me there as she graded. I walked around the blocked 3 times, got some ice water and passed another student. She gave me the thumbs down sign. She looked miserable. She motioned to ask if I had passed and I shrugged. ( Come to find out she forgot gloves while giving heparin) I walked back to my CE..PASS!!!I jumped and hugged her,She told me I had done very well. One done.......more to come....Yvonne GN
I want to let you future CPNErs know a bit more about the room set up. The typical room at St Joe's is a semi private with the bathroom to the left as you enter and a sink immediately beyond that. There is alcohol gel not only on the wall next to the sink but right outsede each patient room.
Okay? Now onward to the rest of my day....
..I went to the cafeteria as directed and bought some coffee and cheese crackers. I had one and couldn't even taste it. The rest of the students filtered in.Two had failed the first one. One I mentioned was no gloves while giving heparin, the other had changed her NDX but did not change her interventions!!! She was devastated. I told her to repeat my mantra after me. I said this whenever I worked out, on a long drive, before I slpet and in the shower," I am confident because I am prepared, I am calm because I am prepared, I am succcessful www.healthjourneys.com. least nightly sometimes twice a day. The author was bellruth Napersak. titled self confidence and performance.I bought a pillow speaker for $6 from radio shack and drifted off to sleep. It helped alleviate stress! Another thing I did for stress control was make up my own mantra that I repeated when ever I worked out drove etc....Mine was: I am confident because I am prepared, I am calm because I am prepared, I am successful, I am an RN. You really need to make up one that works for YOU.I was CALM for my CPNE. I was excited yes, but not the puking in the parking lot kind of nerves I feared.
Next, be good to yourself. Eat, exercise, relax. I know, i know, You don't have time for that...but you do not have time NOT to. How much retention do you think you will have if you do not give your brain down time??The exercises HELPS your brain and gives your stress an outlet. I chose kickboxing because it was so vigorous I was drenched by the end and I felt blissful because the tension was gone.
Make yourself flash card for whatever you have trouble remembering.I wrote my mnemonics out twice a day,everyday.If you work in a clinical setting, be sure you adjust your work practices to include asepsis and checking ID bands. Practice vitals on your kids, pets and visitors.Careplan your family. I did!!
Okay Careplans. This was my nemesis.As Stu told me the CPNE revolves around your careplan all you do is:plan what you will do to your patient,do what you planned, write what you did and the patient response....done!! I know it is simplified but as You study it will make more sense.
A careplan does not have to be elaborate, just applicable.The goal does not have to be accomplished during the PSc because we are not there for our test alone but for THAT patient!!! If your goal is not accomplished that is ok!! Just chart it how it happened.an unmet goal does not mean failure!! .try your darndest to use your assigned AOC to form your careplan.Look at your assignment for interventions that you have to do anyways and work backwards. The CEs have NDX in mind when they make up your assignment.For instance, my first Pt was assigned comfort management....but complained of pain 8/10....who was I to choose acute pain as a Dx? NO! I went with Impaired comfort.
I know there are alot of mnumonics out there. be sure whatever ones you go with comply with the critcal elements. Go step by step and compare. Just because someone boasts about theirs does not make them right!!!
The study guide is our authority!!! Do not let people confuse you with rumors and doubt what you know!!! It is all there in writing! There is no secret handshake.
Ear plugs help while you chart to block out sounds of other students and staff. You may not be able to have a private area to chart so block everyone out , turn your back on 'em and shut your ears off!.
As you get closer to your date, read only positive posts.
Smile, it relaxes you
I bought a hideous pen with sparkles and beads on it and placed it on top of my MAR during the Labs so I would remember to sign! I brought two calculators, pencils and highlighters.Highlight everything you will need to fill in and do not be afraid to cross any areas off you are not assigned. If you are not assigned to check an IV or IV lock do NOT touch it!!!
Pray! Our good Lord loves us. Alot of people only think of God when we need him and say he is there in time of stress BUTI believe we take him for granted and he always is there like a good set of tires we only are grateful for during inclimate weather. Be thankful.
Associate with others on this site. We all have the same goal.When you pass be sure to remember those who led you and give a hand up.
This was all MY way. I hope YOU will find what works for YOU.
Yvonne Bush GN
First of all I want all those who are anticipating their own CPNE, that this is soooooooo doable. I took NO workshops. Do not rely on the conventional wisdom from some of the yahoo groups. The ultimate authority is the studyguide. If you know it,do not chase someone's opinion that conflicts. Verify everything.
I did not touch a book or a note the week before my test. My Dear Husband ( DH) kept me occupied without me even realizing that he was doing it. I got a massage on Thursday to loosen up all the knots I got from being hunched over my books for months.My DH had a dozen red roses delivered to me with a card that read" Babe, relax,you will do fine, your sweetie" I kept that card with me the whole CPNE. I printed up a very positive experience and an encouraging email to keep in the car and read before I went in.
I will write my experience in several installments and give as much details as I can.I passed all Labs and PCS with NO repeats.
I obsessed about the right thing to wear on Friday afternoon and finally decided to wear some green because It was St Patricks day. I was supposed to meet DH for lunch Friday but he could not get away. I made back up plans to meet a good friend but last minute his elderly mother needed him. I was upset to be alone to drive the hour to Syracuse alone.
I easily found the St Joes school of nursing. Slowly students filtered into the lobby. There was 5 women. Two from NY, one from PA and two from CA. I decided to set the tone and declared that we had a fine group and I had a good feeling about all of us. I got a few nervous smiles but I decided that I would go in optimistic. We met our CA, Mary, a very Irish woman who also was the director of the St Joes school of nursing!!
We got the whole thing out of the manual.We drew card to get our assignments. I got 1A.
Then to the Labs. When we were allowed to look at the stations ahead of time, I ripped dressings off the mannequins, opened packages , tried on gloves etc.This was MY test. I was looking good and hard.
My first was the IV push lab. I contaminated the syringe by picking it up by the barrel of the plunger of all things!! I caught myself and started over.Everything else went smoothly. The CEs were so relaxed and non intimidating!.2 of the women with me had to redo labs.
My first CE was Peg. I could tell she had a quick wit . We walked out into the cold to the hospital.I got the info on my first patient and my assignment. I had a woman with possible pneumonia, urethral calculi,hydronephrosis,post 2 day stent placement,post brain aneurysm,fibromyalgia.
I was assigned: along with all the usual required AOC, comfort management, respiratory management,medications.Assess pain,assess O2 sat
I drove home elated and obsessing about the next day.
I will write more ...............
Yvonne Bush GN.
okay...onward........ I drove the hour home Friday feeling great that I did not have a repeat lab hanging over my head.I was already working on a careplan in my head.I got home and kissed DH ( Dear Husband) . I sat down and read the kardex twice. I got out my trusty highlighter and marked the areas I needed to fill in on the entire packet. This is my careplan initially......Impaired comfort r/t calculi aeb patient rates pain a ------ on a 0-10 scale ......Goal:patient will rate pain a 3 or less'.......interventions !) assess pain 2) ask primary nurse to medicate with ordered analgesic.
NDX2: Ineffective airway clearance r/t retained secretions aeb abnormal lung sounds. I made a practice grid on a separate piece of paper.I went to bed about 930 PM and slept until 2 am. I had dreams of letters and mnemonics. I finally gave up and showered. I packed each morning some dark chocolate for the benefit of flavanoids and some Greek sesame honey candy,32 ounces of water. Each morning I had a protein shake with a banana in it'd was not sure something else would have stayed down.
I got to the Hospital a bit early and parked in the hospital garage . It is not the best neighborhood so I did not want to leave it on the street, but the rates of the garage was larceny anyways!!! We all filtered in the cafeteria which is pretty nice and dirt cheap with a lot of variety. The students gathered at one table and the CEs at another. We all ended up talking about our assignments even though we were encouraged not to.One by one we got picked up by our assigned CE. I went to the urinary/renal floor .The units at St Joes have the utility rooms in the center , the main nursing station on one end and the rooms are all on the outer areas. There are pods..Or mini nurses stations in niches along the inner block . Each pod serves 3 rooms and has the meds for those rooms as well as the computer for charting there. My CE warned me that my patient was talkative and I nay need to guide her with getting accomplished.As I was in planning she had gotten up to the bathroom and did not void again so I was set there.While doing checks, I noticed that her IV site was edematous so I had to get the primary nurse who did not seem concerned. The patient was upset . There was extensive bruising on her arms from multiple failed IVs.All in all she was a peach, wanting to make my job easier.She rated her painan 8/10 but that included her fibromyalgia too..I notified primary and changed my careplan and told the CE I was including the fibromyalgia in the etiology for the impaired comfort..While she was eating I went out to get her meds.I returned and someone had picked up her tray!!!! The patient was teary and said" I told them to leave it for you" The CE picked her tray off the cart for me...thank goodness it still had the ticket on it.I ended up not getting the blood pressure on her because of ther severly bruised arms . We attempted a leg BP but her fibromyalgia was pretty bad so I invoked CDM and CE agreed.Her lungs were pretty junky and she was cooperative with Resp management.It was a bit difficult to get her to accept comfort management as she thought it wasnt fair to have the student do all of that. I finally convinced her that she was doing ME the favor. I washed her itchy back and gave her a massage. I ambulated her around the block as I had time and she talked the whole time!!.I finished what I had to and out I went. I was out in a patient lounge to chart and put earplugs in to help me concentrate.I handed in my paper............Peg asked me if I needed to get a drink. I dont think she wanted me there as she graded. I walked around the blocked 3 times, got some ice water and passed another student. She gave me the thumbs down sign. She looked miserable. She motioned to ask if I had passed and I shrugged. ( Come to find out she forgot gloves while giving heparin) I walked back to my CE..PASS!!!I jumped and hugged her,She told me I had done very well. One done.......more to come....Yvonne GN
I want to let you future CPNErs know a bit more about the room set up. The typical room at St Joe's is a semi private with the bathroom to the left as you enter and a sink immediately beyond that. There is alcohol gel not only on the wall next to the sink but right outsede each patient room.
Okay? Now onward to the rest of my day....
..I went to the cafeteria as directed and bought some coffee and cheese crackers. I had one and couldn't even taste it. The rest of the students filtered in.Two had failed the first one. One I mentioned was no gloves while giving heparin, the other had changed her NDX but did not change her interventions!!! She was devastated. I told her to repeat my mantra after me. I said this whenever I worked out, on a long drive, before I slpet and in the shower," I am confident because I am prepared, I am calm because I am prepared, I am succcessful www.healthjourneys.com. least nightly sometimes twice a day. The author was bellruth Napersak. titled self confidence and performance.I bought a pillow speaker for $6 from radio shack and drifted off to sleep. It helped alleviate stress! Another thing I did for stress control was make up my own mantra that I repeated when ever I worked out drove etc....Mine was: I am confident because I am prepared, I am calm because I am prepared, I am successful, I am an RN. You really need to make up one that works for YOU.I was CALM for my CPNE. I was excited yes, but not the puking in the parking lot kind of nerves I feared.
Next, be good to yourself. Eat, exercise, relax. I know, i know, You don't have time for that...but you do not have time NOT to. How much retention do you think you will have if you do not give your brain down time??The exercises HELPS your brain and gives your stress an outlet. I chose kickboxing because it was so vigorous I was drenched by the end and I felt blissful because the tension was gone.
Make yourself flash card for whatever you have trouble remembering.I wrote my mnemonics out twice a day,everyday.If you work in a clinical setting, be sure you adjust your work practices to include asepsis and checking ID bands. Practice vitals on your kids, pets and visitors.Careplan your family. I did!!
Okay Careplans. This was my nemesis.As Stu told me the CPNE revolves around your careplan all you do is:plan what you will do to your patient,do what you planned, write what you did and the patient response....done!! I know it is simplified but as You study it will make more sense.
A careplan does not have to be elaborate, just applicable.The goal does not have to be accomplished during the PSc because we are not there for our test alone but for THAT patient!!! If your goal is not accomplished that is ok!! Just chart it how it happened.an unmet goal does not mean failure!! .try your darndest to use your assigned AOC to form your careplan.Look at your assignment for interventions that you have to do anyways and work backwards. The CEs have NDX in mind when they make up your assignment.For instance, my first Pt was assigned comfort management....but complained of pain 8/10....who was I to choose acute pain as a Dx? NO! I went with Impaired comfort.
I know there are alot of mnumonics out there. be sure whatever ones you go with comply with the critcal elements. Go step by step and compare. Just because someone boasts about theirs does not make them right!!!
The study guide is our authority!!! Do not let people confuse you with rumors and doubt what you know!!! It is all there in writing! There is no secret handshake.
Ear plugs help while you chart to block out sounds of other students and staff. You may not be able to have a private area to chart so block everyone out , turn your back on 'em and shut your ears off!.
As you get closer to your date, read only positive posts.
Smile, it relaxes you
I bought a hideous pen with sparkles and beads on it and placed it on top of my MAR during the Labs so I would remember to sign! I brought two calculators, pencils and highlighters.Highlight everything you will need to fill in and do not be afraid to cross any areas off you are not assigned. If you are not assigned to check an IV or IV lock do NOT touch it!!!
Pray! Our good Lord loves us. Alot of people only think of God when we need him and say he is there in time of stress BUTI believe we take him for granted and he always is there like a good set of tires we only are grateful for during inclimate weather. Be thankful.
Associate with others on this site. We all have the same goal.When you pass be sure to remember those who led you and give a hand up.
This was all MY way. I hope YOU will find what works for YOU.
Yvonne Bush GN
posted by taming the beast at 9:41 AM
2 comments
